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How much activity is enough?

With spring on the way (and hopefully in your step), it seems a good opportunity to review the physical activity recommendations for older people (over 65). This may help you decide what actions you would like to take to remain fit and healthy or perhaps regain some fitness you have lost over the last few months.

I am aware that the guidelines seem to change quite regularly. This is only to be expected –  as more research is done, we learn more about the benefits of exercise and, more recently, the pitfalls of inactivity. The main message is that all adults should aim to achieve 150min a week of moderate or 75min of more vigorous physical activity in a week. This should include strength and balance exercises at least twice a week and recognises the importance of strength training to maintain or regain independence.

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The guidelines for exercise older adults

  • Older adults should break up prolonged periods of being sedentary with light activity when physically possible, or at least with standing, as this has distinct health benefits for older people.
  • Older adults should participate in daily physical activity to gain health benefits, including maintaining good physical and mental health, wellbeing, and social functioning.
  • Some physical activity is better than none: even light activity brings some health benefits compared to being sedentary, while more daily physical activity provides greater health and social benefits.

The most important thing here is that although once a week is better than nothing, it is not enough and we need to be doing exercise 2-3 times a week, and some physical activity every day. Unfortunately, there is growing evidence that many people who attend an exercise class once a week are no more active than those who don’t and spend extended periods sitting. No standing activity leads to active loss of bone and muscle

On average, older people sit for 8-12 hours a day, and the longer you sit, the greater the associated risk factors:

  • Less than 4 hours a day on your feet and, there is an active loss of bone.
  • 1-week bed rest, there is a 20% loss of strength and 1% loss of bone mineral density (that’s equivalent to a year’s loss for the average older person).

What are the risk low activity levels

Even if you are fairly active, after just 30 min of sitting, there is an increased risk of:

  • Loss of strength and balance and therefore increased risk of falls;
  • Loss of bone mineral density and increased risk of osteoporosis;
  • Postural Hypotension (blood pressure dropping when moving from sitting to standing and causing dizziness);
  • Diabetes, Heart Disease and Stroke;
  • Hypertension;
  • Increased BMI and reduced muscle/fat ratio;
  • Increased cholesterol levels.

And ith increased habitual sitting/inactivity, the risk factors increase and include:

  • Flection contractures (permanently flexed joints);
  • Cartilage degeneration/Osteoarthritis;
  • Synovial atrophy and dehydration (less supple/more painful joints);
  • Bone and Muscle loss (increased risk of fractures and frailty/loss of independence.)

I realise this sounds alarming, but the evidence is clear and the solution simple.

In summary, do this

Aim for at least 150min a week of moderate or 75min of more vigorous activity in a week

  1. Do some form of physical activity every day.
  2. Do exercises that challenge your strength and balance at least twice a week.
  3. Avoid long periods of sitting.


Contributed by Simon Hanna, a trustee for Forever Active and an NHS Clinical Exercise Specialist for the Falls Prevention Service.


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